Provider Demographics
NPI:1467415620
Name:CHESTER, RALPH L (MD)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:L
Last Name:CHESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 ARLINGTON BLVD STE 121
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-1560
Mailing Address - Country:US
Mailing Address - Phone:434-956-9175
Mailing Address - Fax:
Practice Address - Street 1:463 S LAKE POWELL BLVD
Practice Address - Street 2:
Practice Address - City:PAGE
Practice Address - State:AZ
Practice Address - Zip Code:86040-0856
Practice Address - Country:US
Practice Address - Phone:928-645-5113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ677842084P0800X, 2084P0804X
VA088174400000X
VA01012389962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945441Medicaid
VA187680OtherANTHEM
VA004945441Medicaid
VA187680OtherANTHEM